Novel Antimicrobial External Fixation Device to Combat Pin Track Infection
Abstract
Injuries to the extremities (arms and legs) have become the most common types of injuries experienced by U.S. military personnel in recent conflicts. When long bones of the extremities are fractured, they are frequently initially stabilized by “external fixation.” In external fixation, surgical pins are placed through the skin into the bone on either side of the fracture and then connected to each other with a metal frame/bar. This stabilizes the fracture until a more definitive repair can be undertaken. Unfortunately, the tracks taken by the surgical pins through the soft tissues frequently become infected (pin track infections [PTIs]). PTI has been reported to occur from 11-100% of the time and is usually dealt with by giving antibiotics, either directly to the pin site or systemically, by oral or intravenous administration. In a significant percentage of cases, despite these measures, the pin must be removed or repositioned elsewhere. PTI is also a risk factor for spread of the infection into the marrow space of the bone, a serious infection called osteomyelitis. Ultimately, the best way to deal with PTI is to prevent it from arising in the first place. We now propose a new way to accomplish this task using novel biocompatible materials developed by Novaflux Technologies. Novaflux has developed a way to incorporate very high quantities of active antibiotics and antiseptics into moldable plastics. These antibiotic-plastics are able to prevent biofilm from forming on their surfaces and are actually able to elaborate active drug into the surrounding tissues and fluids, such that no infection can take hold there either. Novaflux antibiotic-plastics are durable, with an anticipated service life of up to a year. Using Novaflux antibiotic-plastics, we envision that external fixation pins can be defended by a “shield” of such materials surrounding the implant at the point of maximum vulnerability (the skin/implant interface where it protrudes through the skin). In this project, we will develop several formulations of appropriate antibiotics in the plastic materials and test their physical and chemical characteristics (e.g., how quickly they are released from the material, etc.). We will then test the most promising materials for their ability to inhibit the growth of disease-causing bacteria experimentally in the laboratory. Upon confirmation of their potency in a culture dish, we will test the materials in several animal models of implant infection. By validating the efficacy of these materials and the plausibility of this approach, we will advance this technology closer to adaptation for actual use in patients.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910670
Entities
People
- Sandeep Kathju
Organizations
- United States Army